The Things I Can Control

I spoke with my clinic’s P.A. today and she gave me some pretty good feedback. Some of it was nerve wracking. Some of it was pretty hard to hear. Some of it gave me hope.

So, we’re going to try again in November. Even if I ovulated late in my cycle this month, there’s not a whole bunch of time left before my period starts which doesn’t give the sperm much time to work its magic. Better to save my money for an insemination with a higher chance of success.

She’s also requested my A1C levels and my TSH levels to confirm that my ovulation isn’t affected by any thyroid issues. We don’t think this is likely, as my doctor would have pointed something like that out already, but it’s good to have the numbers on file.

One thing she pointed out as a potential issue was my BMI. I’ve put on a lot of weight this year, and I wasn’t necessarily in my target zone before the weight gain. I have chronic migraines brought on by two triggers:

  • Hormone changes (ovulation & menstruation)
  • Blood sugar changes (not enough to be hyper or hypo thyroid) bug enough that getting hungry can be pretty scary.

So, I have a pretty terrible relationship with food. I eat because I’m scared of what will happen if I don’t. The better I eat, the fewer calories I consume, the worse and more frequent my migraines become. It’s a terrible contradictory relationship. The healthier I get, the worse I feel.

I’ve had migraines with distressing frequency since puberty but wasn’t officially diagnosed until I was 24. Up until then, I just thought I had headaches that no pain reliever would work to stop. During my observation month while being diagnosed, I had 17 migraine days out of 30. During that time, I was eating better than I’d ever eaten, working out 6 days a week, 2 hours per day. I was at my healthiest and lowest weight since I was 10-years-old.

After a couple different medications including Topomax and Elavil, which all went disastrously, we settled on Imitrex and it’s changed my life. I had no idea how much fear I was living in until I had a medication that could actually stop my migraines. I wasn’t as afraid to go on road trips anymore, to go on a day outing where food would come at unpredictable intervals, workout, eat less, eat healthier. I still had to be cautious. Imitrex is only prescribed 9 pills ever 30 days so I couldn’t push too hard or I’d run out. But, over the last 8 years, I’ve worked my way down to just 2-4 migraines per month. A huge improvement from the 17 migraine days I started with.

Each time I’ve dropped serious weight, my medication has been instrumental in keeping my pain under control. My symptoms are otherwise debilitating and include but are not limited to water spots in my vision making it impossible for me to drive, extreme pain, nausea, water retention and heat intolerance, swelling joints and in extreme cases neurological symptoms like right side facial drooping (similar to what you’d see with a stroke patient).

Back to the PA. She charged me with dropping some weight to decrease my chances of irregular ovulation, gestational diabetes, gestational hypertension, pre-eclampsia, and miscarriage. Having a BMI above 30 doesn’t guarantee these things but it does increase my risk, and diabetes runs in my family.

So…No big deal right? I’ve dropped 60 pounds 4 separate times in my life. Gained it all back obviously, but I’m more than familiar with the process. To get down below a BMI of 30 I need to drop 45 pounds.

Here’s the rub:

  1. Can’t do that in the 3 weeks between now and the next time I’m due to ovulate
  2. I can’t take my migraine medication during pregnancy (a pre-existing major fear)

So my options appear to be:

  1. Hopefully ovulate in November, go for the IUI and hope that my weight doesn’t become a factor in the quality and risk level of my pregnancy.
  2. Take some time off, drop the weight while relying on my medication to manage the inevitable uptick in migraines, and try again when I’m below the recommended BMI limit.

Here’s the frustrating thing, other than the obvious waiting that’s seriously bumming me out right now….

There’s no guarantee that dropping the weight will prevent those things.

It’s been a long time since I’ve felt this defeated. Of all the things that could get in the way of being a mother, so many of which are really out of my control, here’s this one thing that I could have done something about…I had control over this, and I let myself get out of control…I’m just heartbroken.

Weight management has always been and will always be a struggle in my life. My basal metabolism is very very low. It’s very very easy for me to put on weight with the same calorie intake and activity level that others enjoy without thought. Not going to complain about it. That’s my path in life. If I want to be at a healthy weight, I have to work out at a level that someone else might use to train for a competition and constantly calorie restrict.

So, today I went to spin class, hung out after to work out on the elliptical and do some core work. And when I got home, all I wanted to do was cry. I’m terrified of the pain that I know is coming. Even with the medication, I still have to sit with my migraine for hours before I’m sure it’s bad enough that I should use my medication for it. And I can’t mix my meds with OTC pain killers so if I get a headache…I have to guess at how bad it’s going to get.

Anyway, without depressing myself too much further, my tentative plan is to test one more time in November and go for it if I come up positive. After November, if it doesn’t work out, I’m going to take off December and January. I was planning to do that anyway since those are the two busiest times for bookkeepers and the stress would be a bit too much. I’ll use that time off to take a serious shot at my weight, and come back in February to try again.

Damn, I didn’t expect this…


2 thoughts on “The Things I Can Control

  1. Good luck with the challenges you’ll face in the next few months. Getting ready for pregnancy is tough. My partner had a similar experience but her conflicting medication was for anxiety and depression. Weening off the meds and changing to new ones added several months to our wait but ultimately it was for the best. Sending loads of positive energy your way as you continue your journey!

    Liked by 1 person

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